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Under the law, a competent adult Oregon resident who has been diagnosed, by a physician, with a terminal illness that will kill the patient within six months may request in writing, from his or her physician, a prescription for a lethal dose of medication for the purpose of ending the patient's life. Exercise of the option under this law is voluntary and the patient must initiate the request. Any physician, pharmacist or healthcare provider who has moral objections may refuse to participate.

The request must be confirmed by two witnesses, at least one of whom is not related to the patient, is not entitled to any portion of the patient's estate, is not the patient's physician, and is not employed by a health care facility caring for the patient. After the request is made, another physician must examine the patient's medical records and confirm the diagnosis. The patient must be determined to be free of a mental condition impairing judgment. If the request is authorized, the patient must wait at least fifteen days and make a second oral request before the prescription may be written. The patient has a right to rescind the request at any time. Should either physician have concerns about the patient's ability to make an informed decision, or feel the patient's request may be motivated by depression or coercion, the patient must be referred for a psychological evaluation.

The law protects doctors from liability for providing a lethal prescription for a terminally ill, competent adult in compliance with the statute's restrictions. Participation by physicians, pharmacists, and health care providers is voluntary. The law also specifies a patient's decision to end his or her life shall not "have an effect upon a life, health, or accident insurance or annuity policy."

From the act's passage through 2013, a total of 1,173 people have had prescriptions written and 752 patients have died from ingesting medications prescribed under the act.[5] The average age of the 752 patients who died from ingesting medication was 71, with 78.9 percent of patients suffering from malignant neoplasms (cancer). Of the 752, 52.7% were male (47.3% female); 45.6% had a Baccalaureate degree or higher; 46.2% were married; primary end of life concerns were loss of autonomy (91.4%), inability to make life enjoyable (88.9%), and loss of dignity (80.9%).[6]

An independent study published in the October 2007 issue of the Journal of Medical Ethics reports there was "no evidence of heightened risk for the elderly, women, the uninsured, people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations."[7]

In addition to arguments against physician-assisted dying, opponents feared that terminally ill people throughout the nation would flock to Oregon to take advantage of the law. This fear has not been realized, largely because drafters of the law limited its use to Oregon residents.[9] Despite the measure's passage, implementation was tied up in the courts for several years.

Proponents of Measure 51 argued that the Death with Dignity Act lacked a mandatory counseling provision, a family notification provision, strong reporting requirements, or a strong residency requirement.[10] Measure 51 opponents argued that sending the measure back to voters was disrespectful considering they had already passed Measure 16 via the initiative process. They also felt that the safeguards in the Death with Dignity Act were adequate.

Measure 51 was defeated in the November 4, 1997, special election with 445,830 votes in favor, and 666,275 votes against.[11]

In October 2005, the U.S. Supreme Court heard arguments in the case of Gonzales v. Oregon to determine the fate of the Death with Dignity law. Arguing on behalf of the state was Oregon Senior Assistant Attorney General Robert Atkinson. Oregon's five Democratic members of Congress also filed a brief in support of the State's position.[16]United States Solicitor GeneralPaul Clement argued on behalf of the Bush administration, which challenged Oregon's right to regulate the practice of medicine when that practice entails prescribing federally controlled substances. On January 17, 2006, the court ruled 6–3 in favor of Oregon, upholding the law.[17]